Chronic constipation

  Constipation is a common clinical condition, mostly seen in the elderly but also in many young and middle-aged people with the increased stress of modern times. It seriously affects people’s daily life and quality of life.  The medical definition of constipation is – Constipation is a symptom(s) that is mainly manifested by difficulty in defecation and/or reduced frequency of defecation and dry and hard stools. Difficulty in defecation includes straining to defecate, difficulty in passing stools, feeling of incomplete defecation, feeling of anorectal blockage, time consuming defecation and needing assistance in defecation. Decreased frequency of bowel movements means less than 3 bowel movements per week. The duration of chronic constipation is at least 6 months. Therefore, before a diagnosis of constipation can be made, the above conditions must be met. After the diagnosis is clear, it is necessary to find the cause, which is commonly functional, organic and pharmacological. Functional diseases cause constipation mainly due to dysfunction of the neural smooth muscle of the colon and rectum, including functional constipation, functional defecation disorder and constipation-type irritable bowel syndrome. Organic diseases mainly include metabolic diseases, neurogenic diseases, primary diseases of the colon (such as colon cancer), etc. Pharmacological constipation is mainly induced by anticholinergic drugs, opioids, calcium antagonists, antidepressants, antihistamines, antispasmodics, anticonvulsants, etc.  The next issue is treatment. In the treatment of constipation, the cause should be clarified based on the medical history, combined with the necessary auxiliary examinations such as gastroscopy and colonoscopy, and targeted treatment should be taken according to the cause. The first is lifestyle intervention, which mainly includes increasing dietary fiber and water intake, increasing exercise, etc. This is the basic treatment for constipation. Good bowel habits also need to be developed. Second, certain medications such as volumetric laxatives and osmotic laxatives can be used if available. Stimulant laxatives can be used temporarily in case of emergency, but mainly should not be used for a long time. Furthermore, if the constipation is caused by pathological organic diseases such as tumors, surgical treatment is required. There are also functional diseases that cause constipation, which need to be treated with emotional regulation.  In short, do not be nervous when you have constipation, scientific and standardized treatment can improve the quality of life.